Cystic echogenicity on vaginal ultrasound usually refers to a lesion that is found to have fluid-like changes after vaginal ultrasound. Vaginal ultrasound findings of cystic fluid inside the nodule may be due to the presence of cysts or cystic changes in the nodule, which may typically be diseases such as cervical naevus cysts, chocolate cysts, simplex cysts, dermoid cysts, and tubal effusions. The blood supply to these cystic lesions varies, with some cysts having no blood supply and others having abundant blood flow. Specific treatment will be analyzed and determined by the doctor based on the patient’s medical history and symptoms. Vaginal ultrasound-guided puncture can be used to treat pelvic cystic masses, which is highly accurate, easy to perform, short procedure time, less bleeding, less pain and fewer complications. For specific diagnosis and treatment, it is recommended to follow the guidance and medical advice of specialized doctors after examination.